Pre Service Representative

Surgery Partners; United States; Remote; USD 36,000 - 54,000; Full time

Benefits offered by this job

Health Insurance

HSA (Health Savings Account)

Life Insurance

Paid Time Off

401(k) with company match

Job summary

Surgery Partners is seeking a Pre Service Representative to manage pre-operative administrative tasks at the Ambulatory Surgery Center. You will verify insurance eligibility, secure pre-authorizations, and ensure accurate patient demographics for billing.

You will communicate financial responsibilities and provide Good Faith Estimates under No Surprises Act guidelines. The role involves coordinating with physicians and ASC administration, resolving pending or low-reimbursement cases before

Qualifications

• Minimum of two years of front office experience in a medical environment.
• Experience with insurance verification, scheduling, and pre-authorizations.
• Experience utilizing payer portals and understanding payer payment policies and contract reimbursement methodologies.

Responsibilities

• Verify insurance eligibility and coverage.
• Complete insurance pre-authorizations/pre-certifications and document approvals in the billing and electronic document systems.
• Coordinate with ASC administration to obtain approval or reschedule non-authorized or low-margin cases.
• Communicate with patients and families regarding insurance coverage, financial responsibility, and payment requirements prior to surgery.
• Obtain and enter accurate insurance, demographic, and eligibility information into the billing system and register patients in a timely manner.
• Collect and update patient insurance information as needed.
• Collect co-pays, deductibles, and other out-of-pocket payments prior to or at the time of service.

Skills

Initiative & teamwork

ICD-10 coding

CPT coding

Education

High school diploma or GED

Tools

Payer portals

Job description

Surgery Partners is committed to complying with all applicable provisions of the Americans with Disabilities Act, as amended (“ADA”), and applicable state and local laws. It is the Company’s policy not to discriminate against any qualifiedpeople or applicant with regard to any terms or conditions of employment on the basis of such individual’s disability. Consistent with this policy of non-discrimination, the Company will provide reasonable accommodations to an individual with a disability, as defined in the ADA or applicable law, who has made the Company aware of his/her disability, unless doing so would cause an undue hardship to the Company. If you are an applicant and need a reasonable accommodation when applying for job opportunities within the Company or request a reasonable accommodation to utilize the Company’s online employment application, please contact [e-mail]

JOB SUMMARY

The Pre Service Representative manages all pre-operative administrative tasks for scheduled procedures at the Ambulatory Surgery Center (ASC). This includes verifying insurance eligibility, securing required pre-authorizations, and ensuring accurate entry of patient demographics and insurance details for proper billing. The PSR communicates with patients to explain financial responsibilities and provides Good Faith Estimates in compliance with the No Surprises Act. They coordinate with physician offices and ASC administration to resolve any pending or low-reimbursement cases before the date of service. The PSR also documents all actions in the billing system and collects co-pays, deductibles, and other payments prior to or at the time of service.

DUTIES AND RESPONSIBILITIES

Verify insurance eligibility and coverage.

Complete insurance pre-authorizations/pre-certifications and document approvals in the billing and electronic document systems.

Coordinate with ASC administration to obtain approval or reschedule non-authorized or low-margin cases.

Communicate with patients and families regarding insurance coverage, financial responsibility, and payment requirements prior to surgery.

Obtain and enter accurate insurance, demographic, and eligibility information into the billing system and register patients in a timely manner.

Collect and update patient insurance information as needed.

Collect co-pays, deductibles, and other out-of-pocket payments prior to or at the time of service.

EDUCATION

• High school diploma or GED required.

EXPERIENCE

Minimum of two years of front office experience in a medical environment

Experience with insurance verification, scheduling, and pre-authorizations.

Experience utilizing payer portals and understanding payer payment policies and contract reimbursement methodologies.

LICENSE(S)/CERTIFICATION(S)

• None required.

KNOWLEDGE/SKILLS/ABILITIES

Strong initiative and ability to work effectively in a team environment.

Knowledge of ICD-10 and CPT coding.

• Comprehensive health, dental, and vision insurance
• Health Savings Account with an employer contribution
• Life Insurance
• PTO
• 401(k) retirement plan with a company match
• And more!

Equal Employment Opportunity & Work Force Diversity

Our organization is an equal opportunity employer and will not discriminate against any employee or applicant for employment based on race, color, creed, sex, religion, marital status, age, national origin or ancestry, physical or mental disability, medical condition, parental status, sexual orientation, veteran status, genetic testing results or any other consideration made unlawful by federal, state or local laws. This practice relates to all personnel matters such as compensation, benefits, training, promotions, transfers, layoffs, etc.Furthermore, our organization is committed to going beyond the legal requirements of equal employment opportunity to take positive actions which ensure diversity in the workplace and result in a multi-cultural organization.

Surgery Partners conducts pre-employment screenings including but not limited to criminal background checks and drug testing.

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